Effect of different administration timing of aflibercept on BCVA,color Doppler ultrasound parameters and quality of life in patients with proliferative diabetic retinopathy
Objective To investigate the impact of different administration timing of aflibercept on the best-cor-rected visual acuity(BCVA),color Doppler ultrasound parameters,and quality of life in patients with proliferative diabetic retinopathy(PDR).Methods A total of 114 patients(114 eyes)with PDR who were admitted to the Department of Oph-thalmology,the Central Hospital of Jiaozuo Coal Industry(Group)Co.,Ltd.from October 2021 to October 2023 were se-lected for inclusion in the study.They were randomly divided into three groups according to a random number table meth-od:group A,group B,and group C,with 38 cases(38 eyes)in each group.All three groups of patients underwent vitrecto-my.Aflibercept was injected at 3 days before surgery in group A,at 5 days before surgery in group B,and not injected be-fore surgery in group C.The surgical conditions,as well as best-corrected visual acuity(BCVA),color Doppler ultra-sound parameters(peak systolic velocity[PSV],end diastolic velocity[EDV],and resistance index[RI]),vascular endo-thelial growth factor(VEGF)levels in vitreous humor and serum before and at 1 month,3 months,and 6 months after surgery were compared among the three groups.The incidence of complications was compared among the three groups.The scores of the quality of life questionnaire for patients with visual impairment(SQQL-Ⅵ)were compared among the three groups before and at six months after surgery.Results The operation time of patients in group A and group B was(61.61±5.56)min and(63.08±4.79)min,respectively,which was significantly shorter than(80.81±8.46)min of group C;the number of electrocoagulation was(0.56±0.14)times and(0.52±0.18)times,respectively,which was significantly less than(0.84±0.23)times of group C;the differences were statistically significant(P<0.05).The intraoperative blood loss in group A was(15.12±1.33)×106/mL,which was significantly lower than(65.52±6.69)×106/mL in group B(P<0.05).The BCVA of patients at 1 month,3 months,and 6 months after surgery was(1.20±0.30)LogMAR,(0.85±0.30)LogMAR,and(0.71±0.34)LogMAR in group A and(1.16±0.33)LogMAR,(0.84±0.31)LogMAR,and(0.67±0.36)LogMAR in group B,respectively,which was significantly better than(1.45±0.35)LogMAR,(1.01±0.33)LogMAR,and(0.90±0.35)LogMAR in group C,with statistically significant differences(P<0.05).The levels of VEGF in vitreous fluid in pa-tients in group A and group B were(65.65±6.11)pg/mL and(67.11±7.45)pg/mL,respectively,which were significantly lower than(123.34±14.46)pg/mL in group C(P<0.05);there was no significant difference in the levels of VEGF between group A and group B(P>0.05).The serum VEGF levels in patients in group A and group B were(45.05±4.32)pg/mL and(43.99±5.78)pg/mL,respectively,which were significantly lower than(58.44±6.27)pg/mL in group C(P<0.05);there was no significant difference in serum VEGF levels between group A and group B(P>0.05).The PSV and EDV of the ophthalmic artery were(40.42±4.11)cm/s and(15.58±2.36)cm/s of group A and(41.56±3.87)cm/s,(15.71±3.31)cm/s of group B,respectively,which were significantly higher than(36.36±3.53)cm/s and(13.02±1.87)cm/s in group C(P<0.05);the RI of the ophthalmic artery in group A and group B were 0.40±0.22 and 0.42±0.23,respectively,which were significantly lower than 0.63±0.24 in group C(P<0.05);there was no significant difference in PSV,EDV,and RI be-tween group A and group B(P>0.05).The incidence of recurrent vitreous hemorrhage in group A and group B was 5.26%and 10.53%,respectively,which was significantly lower than 31.58%in group C(P<0.05);there was no signifi-cant difference between group A and group B(P>0.05).The SQQL-Ⅵscores of group A,B,and C at 6 months after sur-gery were(163.36±15.55)points,(162.28±16.11)points,and(161.14±18.85)points,respectively,which were significant-ly higher than(100.12±12.36)points,(98.99±15.59)points,and(101.43±11.78)points before surgery(P<0.05);there was no significant difference among the three groups at 6 months after surgery(P>0.05).Conclusion In patients with PDR who underwent vitrectomy,the injection of aflibercept before surgery can shorten the operation time,reduce the number of electrocoagulation,reduce the amount of intraoperative blood loss,improve visual acuity and fundus hemody-namics,inhibit retinal neovascularization,reduce the incidence of vitreous hemorrhage,and improve the quality of life,but the effect of injection at 3 days and 5 days before surgery is similar.
Diabetic retinopathyProliferative stageAfliberceptAdministration timingVitrectomyQuality of life
万方数据
维普
